穴位敷贴联合针刺治疗肠易激综合症临床观察及对脑肠肽5-HT和炎症因子IL-8的影响

Clinical Observation on Treatment of Irritable bowel Syndrome by Acupoint Application Combined with Acupuncture and the Effects on 5-HT and IL-8

目的：探讨穴位敷贴联合针刺治疗腹泻型肠易激综合征的临床疗效以及对血清5-HT、IL-8的影响。方法：将符合标准的60例患者随机分为2组，每组各30例，治疗组行穴位敷贴，每3天贴1次，共贴10次，每次敷贴2-4h，同时针刺太冲、三阴交、天枢、上巨虚、中脘等穴，1次，d，5次为1个疗程。休息2d继续下一个疗程，共治疗4个疗程。对照组口服匹维溴胺，3次／d，50mg／次，进餐时用水吞服，4周为1疗程。治疗前、后采用酶联免疫吸附测定法检测2组患者血清5-HT、IL-8水平，观察其变化情况。结果：治疗组与对照组均能患者血清5-HT及IL-8含量较治疗前均有明显下降，差异具有统计学意义（P〈0．05），治疗组相应5-HT、IL-8含量下降幅度较对照组更加明显，差异具有统计学意义（P〈0．05）。结论：穴位敷贴联合针刺治疗能够通过降低患者血清5-HT、IL-8水平，减轻肠道炎症反应，减弱内脏高敏感性，调节脑肠轴的失衡状态。

Objective： To discuss the clinical efficacy of acupoint application combining with acupuncture treatment of diarrhea-predominant irritable bowel syndrome and the influence on serum 5-HT and IL-8. Methods： 60 patients were randomly divided into treatment group and control group, 30 cases in each group.Treatment group were given treatment of acupoint application once every 3 days, 2-4hours for every time, at the same time they were treated with acupuncture at Taichong, Sanyinjiao, Tianshu, Shangjuxu and Zhongwan once a day and for 5 times. Control group was treated with oral administration of pinaverium, 50mg each time, 3 times a day. Four weeks were taken as a treatment course in both groups. Before and after treatment ELISA method was used to measure the levels of serum 5-HT and IL-8 in two groups. Results： The levels of serum 5-HT and IL-8 were significantly reduced in treatment group com- pared with control group（P〈0.05）. Conclusion： The acupoint application combining with acupuncture therapy achieves the superior efficacy compared with pinaverium in treating diarrhea-irritable bowel syndrome, which can reduce the patients＇ serum 5-HT, IL-8 levels, restrain intestinal inflammation, relieve visceral sensitivity, and adjust the imbal- ance of brain gut axis.